To observe the clinical efficacy of “Xiakucao Fluid” in the treatment of nodular goiter of qi depression and phlegm obstruction  Methods:Sixty-six subjects were randomized into two groups:control group in which 33 cases were treated by Levothyroxin Sodium Tablets, and treatment group in which 33 cases were treated by Levothyroxin Sodium Tablets and “Xiakucao Fluid”, with a course of six months. The clinical efficacy, thyroid nodes and thyroid functions were observed  Results:The total effective rate was 84.85% in the treatment group and 51.52% in the control group, with better efficacy in the treatment group than in the control group(P<0.01). After treatment, the maximal diameters of thyroid nodes were reduced in both groups(P<0.05, P<0.01), with smaller diameter in the treatment group than in the control group(P<0.01); the number of thyroid nodes was decreased in the treatment group(P<0.05), with fewer number in the treatment group than in the control group(P<0.05). The levels of FT3, FT4 and TSH changed little between before and after treatment, and the two groups(P>0.05)  Conclusion:“Xiakucao Fluid” is quite effective against nodular goiter of qi depression and phlegm obstruction.